Development and validation of an aetiology in delirium diagnostic support tool

2020 ◽  
Author(s):  
Eamonn Eeles ◽  
Lisa Huang ◽  
Lucy Dakin ◽  
Carolina Ling ◽  
Erin Dunn ◽  
...  
Keyword(s):  
Median Number ◽  
Expert Group ◽  
Reference Standard ◽  
Support Tool ◽  
Clinical Challenge ◽  
Consultant Physician ◽  
Comorbidity Index ◽  
Stage 1 ◽  
Development And Validation ◽  
Diagnostic Support

Abstract Background recognition of the multifactorial causes of delirium represents a clinical challenge. Objectives to develop and show proof of principle of a diagnostic support tool (DST) for identification of causes of delirium. Methods stage 1—development of the aetiology in delirium-diagnostic support tool (AiD-DST); stage 2—validation of the AiD-DST against reference standard diagnosis, based on clinical assessment from two independent consultant geriatricians. Results a series of eight steps AiD-DST were formulated by an expert group to identify possible causes of delirium. Forty inpatients admitted to a general medical unit with a consultant physician/geriatrician diagnosis of delirium were recruited, consented and reviewed against the AiD-DST. Mean age was 85.1 (standard deviation 7.9) years and 26 (65%) of participants were female. Participants had multiple chronic co-morbidities [median Charlson Comorbidity Index 7; interquartile range (IQR 6–9)] and median number of medications was 8 (IQR 6–11.75). Median number of causes of delirium detected on AiD-DST was 3 (IQR 3–4) versus 5 (IQR 3–6) using the reference standard diagnosis, with sensitivity of 88.8% (95% confidence interval, 81.6–93.9%) and specificity of 71.8% (63–79.5%). Conclusions the aetiology in delirium DST shows promise in the identification of cause(s) in delirium.

scholarly journals Development and validation of the Sorting non-trauMatIc adoLescent knEe pain (SMILE) tool – a development and initial validation study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Clara Guldhammer ◽  
Sinead Holden ◽  
Marina Elmelund Sørensen ◽  
Jens Lykkegaard Olesen ◽  
Martin Bach Jensen ◽  
...  
Keyword(s):  
Knee Pain ◽  
Gold Standard ◽  
Sports Medicine ◽  
Kappa Statistic ◽  
Medical Doctors ◽  
Clinical Tests ◽  
Support Tool ◽  
Expert Clinician ◽  
Diagnostic Flowchart ◽  
Development And Validation

Abstract Background Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain. Method A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10–17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated. Results The final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3–35.1) to 77.3% (95% CI 64.9–89.7). Inter-rater reliability increased from poor agreement k = − 0.04 (95% CI, − 0.12-0.04) to moderate agreement k = 0.56 (95% CI, 0.40–0.72). Conclusion This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.

Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

2016 ◽  
Author(s):  
Po-Hao Chen ◽  
Emmanuel Botzolakis ◽  
Suyash Mohan ◽  
R. N. Bryan ◽  
Tessa Cook
Keyword(s):  
Clinical Practice ◽  
Support Tool ◽  
Diagnostic Support

scholarly journals Sesame, Pistachio, and Macadamia Nut: Development and Validation of New Allergenic Systems for Fast Real-Time PCR Application

Foods ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 1085
Author(s):  
Martina Torricelli ◽  
Elisa Pierboni ◽  
Cristina Rondini ◽  
Serena Altissimi ◽  
Naceur Haouet
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Food Processing ◽  
Annealing Temperature ◽  
Limit Of Detection ◽  
Food Samples ◽  
Support Tool ◽  
Macadamia Nut ◽  
Real Market ◽  
Development And Validation

Food allergy is a worldwide health problem that concerns infants to adults. The main health risk for sensitised individuals is due to the presence of traces of allergens as the result of an accidental contamination during food processing. The labelling of allergens such as sesame, pistachio, and macadamia nut on food products is mandatory according to Regulation (EU) N. 1169/2011; therefore, the development of suitable and specific analytical methodologies is advisable. The aim of this study was to perform a multi-allergen real-time PCR system that works well in fast mode at the same annealing temperature and with the same thermal profile. The real-time PCR was developed designing new, specific, and efficient primer and probe systems for the 2S albumingene for sesame and pistachio and for the vicilin precursorgene for macadamia nut. These systems were subjected to a robust intra-laboratory qualitative validation process prior to their application, by DNA extraction and fast real-time PCR, on some real market samples to reproduce a potential allergen contamination along the food chain. The developed system results were specific and robust, with a sensible limit of detection (0.005% for sesame; 0.004% for pistachio; 0.006% for macadamia nut). The performance and the reliability of the target systems were confirmed on commercial food samples. This molecular approach could be used as a screening or as a support tool, in association with the other widespread monitoring techniques (such as ELISA).

scholarly journals Development and Validation of the Sport Emotion Questionnaire

2005 ◽  
Vol 27 (4) ◽  
pp. 407-431 ◽  
Author(s):  
Marc V. Jones ◽  
Andrew M. Lane ◽  
Steven R. Bray ◽  
Mark Uphill ◽  
James Catlin
Keyword(s):  
Concurrent Validity ◽  
Model Fit ◽  
Item Pool ◽  
Specific Measure ◽  
Separate Sample ◽  
Stage 4 ◽  
Confirmatory Factor ◽  
Acceptable Model ◽  
Stage 1 ◽  
Development And Validation

The present paper outlines the development of a sport-specific measure of precompetitive emotion to assess anger, anxiety, dejection, excitement, and happiness. Face, content, factorial, and concurrent validity were examined over four stages. Stage 1 had 264 athletes complete an open-ended questionnaire to identify emotions experienced in sport. The item pool was extended through the inclusion of additional items taken from the literature. In Stage 2 a total of 148 athletes verified the item pool while a separate sample of 49 athletes indicated the extent to which items were representative of the emotions anger, anxiety, dejection, excitement, and happiness. Stage 3 had 518 athletes complete a provisional Sport Emotion Questionnaire (SEQ) before competition. Confirmatory factor analysis indicated that a 22-item and 5-fac-tor structure provided acceptable model fit. Results from Stage 4 supported the criterion validity of the SEQ. The SEQ is proposed as a valid measure of precompetitive emotion for use in sport settings.

scholarly journals DAYS ALIVE OUTSIDE HOSPITAL AND RE-ADMISSIONS IN PATIENTS UNDERGOING ALLOGENEIC TRANSPLANTS FROM IDENTICAL SIBLINGS, UNRELATED DONORS OR HAPLOIDENTICAL DONORS “.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020055
Author(s):  
Federica Sorà ◽  
Patrizia Chiusolo ◽  
Luca Laurenti ◽  
Idanna Innocenti ◽  
Francesco Autore ◽  
...  
Keyword(s):  
Stem Cell Transplant ◽  
Median Number ◽  
Hemopoietic Stem Cell ◽  
Strong Impact ◽  
Cell Transplant ◽  
Graft Versus Host ◽  
Donor Type ◽  
Unrelated Donors ◽  
Comorbidity Index ◽  
Grade Ii

We have studied the number of days alive outside Hospital (DAOH) and the number of re-admissions within the first 100 days after transplant in 185 patients who received an allogeneic hemopoietic stem cell transplant (HSCT). The donors were matched siblings (SIB; n=61), or alternative donors (ALT; n=124). The median number of DAOH for SIB transplants (78 days) was significantly greater than DAOH for ALT donor grafts (73 days) (p=0.0003) . Other positive predictors of DAOH were the use of reduced intensity regimens (p=0.01), grade 0-I graft versus host disease (GvHD) (p=0.0006) and a comorbidity index equal or less than two (p=0.04). Fifty one patients required re-admission (22%), which was predicted by grade II-IV GvHD (p=0.009), higher comorbidity index (p=0.06) and ALT donors as compared to SIBS (p=0.08). The CI of re-admission was 18% for SIB and 30% for ALT donor grafts. The non relapse mortality (NRM) for patients re-admitted was 25%, compared to 5% for patients not readmitted (p=0.0001). In a multivariate analysis re-admission was the strongest predictor of non relapse mortality (NRM) (p=0.0006) and survival (p<0.0001). In conclusions: ALT donor transplants have lower numbers of DAOH, as compared to SIB grafts, which implies longer stay in hospital and greater cost. Re-admission to Hospital within 100 days, is predicted by GvHD, comorbidity index, donor type, and has a very strong impact on non relapse mortality and survival.

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